155 Dow St #401, Manchester, NH 03101,
United States

Tooth Replacement

#1 Tooth replacement services in Manchester

In the past, if you lose teeth then there were only a few options available for replacement. Our permanent teeth are meant to be with to do a lifetime of function, but things are not destined to be that way always. You may suffer tooth loss for reasons like accident, decay, or gum disease. You may feel discomfort and lose the delicate balance of your mouth for even one tooth loss. Many escalating problems arise as teeth slowly lean and migrate into the extra spaces, wear and cracking from excessive force.

In today’s time, there are several options available to you for replacing missing teeth, whether it’s a one or a full set. With dental implants, you can enjoy normal chewing and a delightful smile, even though there are other options that deserve consideration.

It is not easy for you to sort through the different options and complicated possibilities. We at Manchester Family Dentistry have a background in restorative dentistry and help you to find the right solution for every emerging scenario.

IMPLANTS

FULL OR PARTIAL DENTURES

PORCELAIN BRIDGES

Don’t let missing teeth affect your quality of life any longer – contact us today to schedule a consultation and learn more about our tooth replacement services in Manchester.

Implants

Dental implants in the place of missing teeth bring back your mouth to full functionality and better oral health. Porcelain reproduces natural teeth perfectly, no matter whether it is one or more than one missing tooth. Single crowns or complex bridges can be assisted by implants, with solutions for every possible case.

A perfect long-term solution will be to use implant-supported dentistry that brings you close to growing new teeth as possible. It will be placed in an expertly way to the same bone, with this you will enjoy the strength and functionality of the natural teeth. With the help of modern porcelain, you can get results that are so life-like that you can not distinguish the difference. Dentures can also be attached to implants when the number of teeth replaced is more than one. With Implants you will develop high levels of confidence and stability in your life.

Our proficient doctors at Manchester Family Dentistry use state-of-the-art technology to collect all the data needed to help plan your restorative case. We use valuable technology for this procedure like 3D mapping, Digital x-rays, models, and photographs. Our specialists at Manchester Family Dentistry analyze and bring all the elements of your case together. But consistently, they assist as the quarterbacks of the whole plan.

Many of our patients find the plan and procedure for a dental implant to be easier than they have predicted. The type of sedation may change according to your comfort level, that’s why you need to freely discuss them with our doctors. The site is numbed using the modern dental anesthetic, and the implant is carefully placed using our experienced hands. A very small guide hole makes a path for threading a small implant cylinder into position. Into that exact position, the sterile piece is inserted, with the smooth cover and healing cap that protects the implant during the restorative period.

In some instances, a permanent or temporary crown may be embedded at the time of the surgery. The same procedure is applied for the processes involving multiple implants, which helps to bring back your confident smile.

Implants cannot bear the normal bite forces until the bone is fully integrated into the implant body. Our professional doctors at Manchester Family Dentistry will help you to find out what will work best for you during the early restorative period. They will also ensure that you are able to perform your daily routine while protecting your implants. The time period required to grow bone around the implant usually lasts around 3-6 months. Compared to an extraction, the patients face minimal discomfort after the placement of implants.

One Of Healthcare’s Greatest Values

It is really important to consider the cost that will cover your dental implant procedures. We bring to you the latest imaging, advanced training, and unique materials technologies as well as one of the best modern health care in Manchester. In comparison to the replacement of other hard structures and body joints, dental implant procedures cost significantly less. Most patients continue with day-to-day activities right away and generally enjoy a lifetime of normal chewing, appearance, and bite stability. We understand the importance of creating a completely personalized plan for you and serving you with the best services.

Several critical factors that are unique to each patient are involved in the determination of the cost of dental implant services. If we quote a fee that does not involve careful evaluation then it will not only be incomplete but also will not consider your oral condition separately. Our proficient doctors at Manchester Family Dentistry create a custom treatment plan for you after evaluating your current oral conditions, needs, wants, and budget as well.

Be sure that you will get the best possible value in modern implant dentistry. This implies you will enjoy years of natural function along with a proud smile on your face. We are waiting to discuss how we can partner with you to bring you the best solutions.

Full or Partial Dentures

In many scenarios, a removable dental appliance proves to be the go-to as well as the best method to replace the missing teeth. With careful consideration, we at Manchester family Dentistry, decide whether a partial denture or a complete denture would recover your mouth to the ideal function and appearance. Sometimes it is better to use a combination of dental implants and dentures to get better results.

Dentures are an affordable option to rebuild your smile and they possess a bigger demand as well as a long history of success.

Dentures are used in place of missing teeth as a removable substitute. Complete dentures are implemented when a person has lost all their natural teeth. On the other hand, a partial denture is done when only a few teeth are missing, to eliminate gaps or to improve chewing. A denture treatment varies from patient to patient in accordance with their customized need. Our expert doctors at Manchester Family Dentistry can help you figure out which option fits you the best.

Full Dentures

In many cases dental conditions like gum disease and tooth decay become uncontrollable. This may result in taking a decision like removing the teeth present on one or both arches. This is where Full dentures help you to restore your oral function and smile using an efficient yet economic way.

A thin gum-colored acrylic base is used in a complete denture that rests on the gum tissue. Acrylic or Porcelain substitute teeth built into the base give the look of natural teeth. We value your unique smile, that’s why our doctors at Manchester Family Dentistry are putting together experience and expertise to help you get the most natural and best fitting smile possible. There are also options available to custom-make the way you look: you can choose between getting a completely new smile or restoring the one you had.

Along with the long and history of successful dentures use, we combine modern technology to enhance the way dentures fit and the way you look. On many occasions, dentures can be secured to the jaw with dental implants established in the jaw. Besides having greater retention and a more innate look, the dentures supported by implants have less bone resorbtion. Our helpful doctors at Manchester Family Dentistry will discuss these preferences and assist you to understand the ways that will improve your experience with dentures.

Partial Dentures

Smiling and chewing got severely affected because of the gaps formed due to tooth loss, whether it is one or more than one. A partial denture is an economical solution for replacing your missing teeth of yours, filling in the spaces, improving your chewing ability as well as bringing back your confidence to smile. A partial denture will likewise assist with holding your normal teeth back from moving, bringing down the chances of losing those teeth later on.

In most partial dentures, there is a thin metal structure present that is planned with metal clasps that fold over the gum line of your existing teeth. This takes into consideration a smooth, non-cumbersome feel. Where the teeth are missing, natural-looking replacement teeth are attached, and gum-colored acrylic is used to cover the metal system. Keeping in mind your mouth and your necessities we at Manchester Family Dentistry work with talented specialists to create a solution that is comfortable, functional, and attractively delightful.

With the development in innovation and technology, implants can likewise be utilized to help removable partial dentures, working on the perfect fit as well as lessening the bulkiness of the appliance. Dentures innately bring a few difficulties, particularly to new wearers. We want to limit everyday dissatisfaction and keep you as pleasant as possible.

We are looking forward to discussing your choices and options to make your mouth full again as well as bringing your confident, glowing smile back.

Teeth Grinding

The hardest substance present in our bodies is our teeth and these can withstand an enormous amount of force. But they can face damage, particularly when grinding forces begin to wear them away. If you have a habit of nighttime grinding or clenching then that will harm your teeth, muscle, and jaw joints over time. The protection against abrasive forces is very critical.

Normal chew results in short intervals of contact between teeth. Your teeth should only contact for about 5 minutes each day under normal circumstances. Little amounts of wear over time of use are common, and bite edges can chip a little.

Sometimes, patients have teeth emerging with a flattened, worn appearance, even among the young patients. X-rays may show uncommonly thin layers of enamel as though chewing surfaces of the teeth have been drawn across by the sandpapers. A few minutes of chewing daily is not going to erode the enamel of your teeth so much.

You Don’t Even Know

A subconscious habit of grinding teeth, either during the day or night, is developed in some patients. Often, the abrasive action happens only during sleep, and for just a few seconds at a time. In case you wake up with a sore jaw or a morning headache, this may indicate that you are grinding your teeth during sleep. In certain patients, extended jaw muscles develop on the sides of the face because of the grinding during nighttime. These muscles are one the strongest in our body, which indicates that they can do a lot of unnecessary damage.

The unusual activity not only wears down our teeth but also strains the overworked muscles. The intricate jaw joints present on one or both sides of the mouth can also be damaged because of the comprehensive forces. The damage done to the joints can lead to arthritic changes, chronic pain, and popping or clicking. In case these changes settle in, then it may become impossible to reverse the condition.

Avoiding Irreversible Damage

We recommend you to consult with our doctors at Manchester Family Dentistry if you are waking up with a sore jaw or headache or if you observe flattening or chips of your teeth. The earlier the problem receives consideration, the lower damage there will be. In many cases, a carefully calibrated night guard will eliminate the symptoms and protect your precious enamel as well.

The clenching or grinding habits in the daytime also deserve attention. Our proficient doctors at Manchester Family Dentistry will analyze your bite as well as examine if they’re moving against each other correctly during chewing. It will save a lot of money and time by eliminating the stain on the jaw and teeth at the earliest.

Sleep Apnea

We always look after the overall health of our patients, which includes their oral health as well. Numerous people suffer from many dangerous and disruptive sleep disorders which keep them from getting enough oxygen at night. Data show that a person with a sleep disorder possesses a risk of heart attack that is 23 times higher than that of a normal person and about 92% of the stroke victims live unknowingly with this condition before having a stroke. We at Manchester Family Dentistry offer you education and treatment surrounding sleep health in the most cost-effective as well as the simplest way possible.

Some estimations suggest that more than twelve million Americans have obstructive sleep apnea. Most of the cases are still undiagnosed, and that is contributing to conditions like diabetes, high BP, congestive heart failure, hypertension, coronary artery disease, and traffic accidents related to drowsy driving. There is a very crucial role of dentistry in treating this silent epidemic. The American Academy of Sleep Medicine suggests oral appliances as primary therapy for handling mild to moderate obstructive sleep apnea and for patients having severe sleep apnea who can’t tolerate CPAP treatment.

What Is OSA?

The characteristics of OSA which is a breathing disorder include brief interruptions of breathing in sleep due to airway blockage. We get to see obstructions when the throat muscles, the tonsils, tongue, or the soft palate relax and cover the airway and prevent breathing. As a result of obstruction, there is a severe drop in the blood oxygen levels whole the night.

To diagnose OSA usually, a polysomnogram or sleep study is performed. In the course of a sleep study, a sleep physician monitors body system functions and brain activity while a patient relaxes overnight at a sleep lab. With the data collected from the process, the sleep doctor diagnoses the sleep disorder and recommends the appropriate treatment. If prescribed by the sleep doctor, a dentist qualified in sleep medicine also joins with them to treat obstructive sleep apnea with the help of oral appliance therapy.

How Is OSA Treated?

To treat snoring and obstructive sleep apnea doctors may use procedures like surgery, CPAP or BiPAP machines, or oral appliance therapy. Oral appliances give the minimally invasive option and are often a great choice for treating mild to moderate OSA. To comfortably hold the jaw in a proper position throughout the night, a carefully calibrated appliance like CPAP or BiPAP is used.

All the recommended treatments should be prescribed with the help of your sleep physician. If appliance therapy is chosen, the correct method and placement are crucial to accurately maintain an open airway.

Teeth Whitening

Smile acts as a self-confidence booster and it is really important to live a healthy as well as happy life. But what if you are embarrassed to smile because of your yellow teeth?

We are here to bring your smile back. A process known as Teeth whitening can remove the years of dingy stains from your teeth. Substances like tea, coffee, wine, tobacco, and chocolate dull the white enamel of your teeth. The dazzling whiteness of your teeth can be brought back using a brilliant boost and some gentle polishing as well as reshaping the chipped and uneven edges of your teeth.

There are numerous products stacked on supermarket shelves promising to solve this issue. We are not discouraging you to use these products, but it is always better to get a professional whitening treatment.

Customized system:
With our years of professional experience, we have developed a customized system so that our patients can get their years of stains removed in a matter of a couple of hours. We also create trays that can fit your teeth and helps to whiten the teeth even at home. We will get together and find a suitable situation for you as well as get the best results. We sometimes combine these two systems to get both short-term and long-term benefits.
Controlled gel formulas:
We put priority on safety and consistency while using the highest quality whitening formula. We also provide your teeth with professional strengths using known sources. Be careful of temperature-sensitive gels that are stored in uncontrolled environments or made in an unknown setting.
Sensitivity management:
There are chances that you will experience temporary sensitivity in your teeth during the whitening process. We have developed some specific strategies for you along with this we will customize the methods and products to help you have a safe as well as comfortable experience.
Long-term results:
It generally adds up to a large amount if you are buying a box of whitening strips every few months. Your first session with us can provide an instant effect that otherwise may take multiple boxes of strips and even days to achieve. You are also going to get a system that should fit for years if you are leaving with custom trays. A simple refill syringe of gel picked up from our office can keep your smile fresh for years to come.

Our teeth whitening can give a predictable boost to both your smile and confidence. We at Manchester Family Dentistry with our years of experience deliver you a smile boost safely and comfortably. We are happy to answer any questions you have.

Porcelain Veneers

We at Manchester family dentistry become the happiest persons on earth when we witness our patients get back their magnificent smiles. Veneers can drastically transform a smile, which is also called instant orthodontics. After using Veneers effectively, it can correct stains, chips, and even deeply discolored teeth. But they can as well transform the size and length of teeth or help provide the look of a straight tooth where there is not. This may sound dramatic to you, isn’t it? Veneers provide a high traditionalist approach to esthetic and beautiful smile makeovers.

Veneers are considered one of the supreme and ultimate combinations of dental art and science. This is handcrafted and tailor-made to fit your smile. These paper-thin slices of porcelain bond to the outside surface of your natural teeth. But do not misunderstand that these are not effective as they are thin. Veneers are extremely versatile as well as they can replicate all the complicated nuances of our natural teeth.

Good Planning Paves The Way

A lot of careful planning and a lot diagnostic processes goes into creating a treatment plan that includes veneers. There are different models, photographs, and digital x-rays that can allow you and doctors to create the best treatment plan from the start to finish. The projects can be a great success if we stuck to the planning and follows it effectively. We at Manchester Family Dentistry are always seeking input and incorporation from your end about your desire into your veneer case, starting from the color to shape to everything in between.

The Next Steps

Once a strategic plan is prepared by our doctors at Manchester Family Dentistry for your case, it only needs two appointments before you get a stunning new smile. At the very first visit, your teeth are prepared to allow some space for the very thin porcelain to be crafted by a master lab technician.

After the first visit, our proficient doctors at Manchester Family Dentistry will create a temporary acrylic restoration that imitates the veneers. You need to wear this for up to three weeks. These temporaries help to get a preview of how your new smile will look and you can try it out to see if any further improvements are needed.

Delivering The Magic

After we have successfully created your veneers, then you will return to Manchester Family Dentistry for your second appointment. Each veneer will be tried out and the appearance, as well as the fit, will be evaluated. This will provide you with an opportunity to preview how your new smile will look. They will proceed through multiple steps to precisely bond the thin veneers to the surface of the teeth, generating a very strong bond between tooth and porcelain. It will take only a few minor adjustments to your bite, and a final polish will leave you with a beautiful and wonderful smile.

Adult's Dentistry

Adult dental problems are gradual processes, they start with a little bit of tooth decay or gum infection and then lead to significant problems. Nonetheless, one thing is sure. If left untreated, they quite often result in suffering, emergency treatment, and tooth loss. So, for what reason does this happen?

It’s An Infection.

An enormous amount of bacteria swim around in our mouths, out of which many are harmless, and some are beneficial as well. But some bacterias wants to destroy the hard as well as delicate tissues of the mouth. Like every living organism, they need an energy source. Sugars are their favorite snacks, and they utilize simple carbohydrates from our diet to fabricate energy.

All living organisms consume energy and produce waste, the same happens in bacteria. The acidic wastes produced by them are stored on the teeth, which afterward erode the hard surfaces, debilitate the enamel, and create holes known as cavities.

Some bacterias produce a harmful waste that causes bleeding gums, and damage to the bone around the teeth, which is called Periodontal disease. Periodontal disease is the main explanation for individuals losing their teeth and ending up with dentures.

Most infections can be treated with an antibiotic, however, mouth bacteria require an alternate methodology. Regular checkups assist us with finding new cavities, and occasional cleanings eliminate plaque and tartar that nurtures many damaging bacterias.

Patients with high risk are treated using the custom-made approach with our teams and we have numerous techniques to strengthen debilitated weakened enamel that has not yet developed into decay.

The complex cycle of inflammation and contamination reaches far beyond gums and mouth. Research keeps on uncovering the numerous ways that our oral health influences the general health including heart wellbeing, and can impact medical conditions like joint pain, diabetes, and a few other kinds of disease. For instance, mouth bacteria enter the circulatory system through inflamed and bleeding gums. The bacterias enter the small blood vessels of the heart and brain using the blood flow. Inside the heart and brain, they can harm the intricate vessel lining, prompting blockage of the vessel. A heart attack or stroke can result due to bleeding gums.

SOME TIPS FOR MAINTAINING A HEALTHY MOUTH:

Brush for no less than two minutes, two times per day, and floss no less than one time each day:

It seems like quite a long time, however it has an effect. You can use an electric toothbrush with an in-built timer or set a timer on your cell phone. If you do not like to floss, think about using toothpicks, proxabrushes or the magic of a Waterpik.

Wash your toothbrush and replace it every three months:

Many bacterias reside on the toothbrush, if we do not wash them before and after brushing then the bacteria can enter our mouth again.

Drink sugar-rich fluids using a straw:

A straw helps to prevent sugar from washing the teeth before swallowing. As a result, the probability of tooth problems reduces.

Drink water after your meal:

Water helps clean food residues from your teeth. Besides this, water can help us to stay hydrated and healthy.

Get cavities treated right away:

Cavities rarely cause pain until they arrive at a critical stage. Remember that a small tooth decay eventually becomes bigger. So, get the cavities treated right away.

Visit your hygienist every six months:

The risk of major and critical dental issues decreases drastically if you’re visiting us two times every year. Patients that fit preventive dentistry into their schedule and budget, commonly have fewer dental visits and lesser expenses in the long run than the people who wait for emergencies to develop.

Periodontal Therapy

A recent CDC report provides the following data related to prevalence of periodontitis in the U.S.:

47.2% of adults aged 30 years and older have some form of periodontal disease. Periodontal disease increases with age, 70.1% of adults 65 years and older have periodontal disease.

This condition is more common in men than women (56.4% vs 38.4%), those living below the federal poverty level (65.4%), those with less than a high school education (66.9%), and current smokers (64.2%)

Periodontal disease, also known as gum disease is one of the top reason for tooth loss in adults. This chronic condition gives rise to numerous denture cases. While not curable, but controllable with a devoted as well as proficient hygiene regimen and consistent at-home care.

In the beginning phases, gum disease can advance with not many signs or side effects. Numerous patients who are diagnosed to have this condition experience no pain and are amazed by the quiet yet quick harm that periodontal disease leaves afterward. To understand it better, think about the gums and bones around your teeth as the foundations of a house. As in the case of a house, the foundation needs to be strong, so in the case of teeth also. If the foundation deteriorates then the rest of it does the same.

To detect and strategically manage periodontitis you need to perform regular dental exams, professional cleanings, and good oral hygiene practices at home

What Causes Gum Disease?

Our mouths give a home to a huge number of microbes, both helpful and harmful. Bacterial waste creates a tacky substance, known as plaque, which sticks to the teeth. Brushing and flossing target eliminating plaque before it mineralizes into tartar. Afterward, tartar turns into a home for additional microbes to release toxins into the gums.

Gums react to this bacterial invasion with an inflammatory reaction because of your immune system. Around the foundation of every tooth, there is a small collar of gum tissue that forms a small pocket. This warm and dark environment provides a suitable habitat for drawing in tartar and bacteria to invade.

Early inflammation brings about bleeding gums, known as gingivitis. If the microbes are left untreated and undisturbed effectively, then they make chronic infection in the periodontal pocket. Generally speaking, the bone starts to weaken around the teeth. While gums might be slightly delicate at this stage, there’s for the most part an insignificant discomfort as the bone starts to erode.

Over half of the bone around your teeth can vanish before any indications of looseness or pain show up. The bone around teeth never recovers, so this pain becomes permanent and harder to control as the microbes hide deeper into the gums. Untreated gum illness prompts abscesses and tooth loss in many advanced cases.

Mouth-Body Connection

Many research shows a link between bacterial disease in your mouth and illness in other parts of your body. Some research shows a strong link between oral bacteria and other conditions for instance heart disease, arthritis, stroke, Alzheimer’s, and even some types of cancer. The connection between oral health and whole-body health has never been more understood than it is today.

As the bleeding gums provide a direct pathway into the bloodstream, the oral bacterias quickly enter the other parts of the body. It is similar to an open wound on your skin and can be very harmful to your overall health. This is the reason why researchers are continuing to identify oral bacteria deposits in different parts of our bodies.

Our body’s ability to fight infection lowers because of diabetes and other auto-immune disorders. This results in uncontrolled gum disease progressing at a faster rate and causing more harm. Research tells that inflammation in the mouth can worsen diabetes, making it difficult to control. This interlink between two chronic conditions tells how important it is to take care of our oral health.

Diagnosis

Before making a gum disease diagnosis we take into consideration several factors. The pocket which is a small collar of gum around each tooth generally sits 2-3 mm deep. This space can be easily cleaned by floss or toothpicks. Our proficient doctors or our hygiene team can measure as well as chart multiple areas using a small yet effective measuring device called a periodontal probe. In case these measurements are more than 3 mm and these bleed upon probing then periodontal disease is present. Here deeper reading indicates that the disease is more advanced. We at Manchester Family Dentistry will also examine and evaluate the shape and texture of your gums and any significant movement in each tooth. Alongside this, it is also vital to examine the shape, level, and density of the bone on digital x-rays. After collecting all the data a clear understanding of your gum condition is established.

Treatment

A personalized treatment plan can be prepared after a diagnosis that tells the severity of gum disease. When it is in milder form with little or no bone loss, then one or two visits with our hygiene team will be enough to bring it under control. A strategic home care routine and an established schedule prepared by our team will make the condition better with little additional treatment.

In case the inflammation is big and the measurable bone loss is significant, then you need to consider a strong proactive approach to stop further deterioration. Often, we will propose soft numbing of your gums, and a more thorough cleanup process called root planing or scaling. It will take a few visits to clean up the mouth, as a portion of your mouth at a time will be deep cleaned. We will carefully clean the infected pocket around each tooth, including the mineralized tartar. These are cleaned using ultrasonic instruments and hands. After that polishing is done which establishes a glassy surface that helps to repel stain and plaque accumulation and it usually finishes the initial therapy.

Our proficient doctors at Manchester Family Dentistry may recommend a medicated rinse, an electric toothbrush, Waterpik and other specified strategies to help you with your home care routine and your oral hygiene. Remember that we can only control gum disease but cannot cure it. It requires consistent and dedicated efforts to control this disease.

Maintenance Matters

Regular home care of your oral health is very important to control the progression of gum disease. Within the first few hours of cleaning the bacteria, it again begins to populate and adhere to the teeth. Within 24 hours the plaque is left undisturbed, then it will start to harden and mineralize within 24 hours. Keep in mind that deeper gum pockets require even more perseverance to stop the bacteria from undermining and weakening the foundation of your teeth.

A faithful maintenance schedule is important as the gum pockets previously damaged by bacteria are hard to recover. Depending on the severity of the disease, we can create a customized plan to include 2, 3, or 4 visits a year. This also depends on the response to treatment and the consistency of home care.

In case our combined and consistent efforts don’t slow or stop the progression of the gum disease, then we will suggest referral to a specialist in this field known as a periodontist.

#1 Tooth replacement services in Manchester

IMPLANTS

FULL OR PARTIAL DENTURES

PORCELAIN BRIDGES

Implants

One Of Healthcare’s Greatest Values

Full or Partial Dentures

Full Dentures

Partial Dentures

Porcelain Bridges

A Better Bridge

XYZ

Dr. Hitesh Vij

Dr. Suman Reddivari

Dr. Gaurav Malik

Braces

SureSmile®

SURESMILE® CAN:

Something For Everyone

Invisalign®

INVISALIGN® CAN:

Something For Everyone

Teeth Grinding

You Don’t Even Know

Avoiding Irreversible Damage

Sleep Apnea

What Is OSA?

How Is OSA Treated?

Extractions

Bone Grafting

Oral Surgery

Teeth Whitening

Gum Contouring

Onlays

Porcelain Crowns

One Simple Step

Composite Fillings

Porcelain Veneers

Good Planning Paves The Way

The Next Steps

Delivering The Magic

Ortho Screenings

The Usual Track

Adult's Dentistry

It’s An Infection.

SOME TIPS FOR MAINTAINING A HEALTHY MOUTH:

Teen's Dentistry

Tips For Home Efforts That Protect Your Teen’s Dental Health:

Children's Dentistry